The green divide and heat exposure: urban transformation projects in istanbul

Extreme heat events are happening more frequently and with greater severity, causing significant negative consequences, especially for vulnerable urban populations around the globe. Heat stress is even more common in cities with dense and irregular planning and lacking urban blue-green infrastructures. This study investigates the greening and cooling effects of five selected urban transformation projects and their surrounding areas (within a 10-min walking distance) in Istanbul from 2013 to 2021, with a focus on environmental justice and climate adaptation planning perspectives. By employing temporal analysis of Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST) values derived from Landsat data sets to detect changes in these five selected urban transformation projects in the megacity of Türkiye, Istanbul, this study finds that the distribution of green infrastructures (e.g., tree canopy) is only limited to project sites of long-running and state-supported urban transformation projects in Istanbul. Consequently, the unequal distribution of green infrastructures creates cooling effects only for the locals residing in the new residential projects. However, the surrounding areas have less urban green infrastructure and are exposed more to the urban heat over time. Urban development policies and planning highly contribute to increasing the climate vulnerabilities among those who do not benefit from the recently developed residential units in Istanbul. Such a trend can affect adaptive capacity of vulnerable communities and redress environmental injustices in urban planning in the megacity of Istanbul

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Effects of Cd+2, Cu+2, Ba+2 and Co+2 ions on Entamoeba histolytica cysts

WOS: 000208223800031PubMed ID: 14760778AIM: The effects of cobalt, copper, cadmium and barium ions on the cysts of Entamoeba histolytica (E. histolytica), an amebic dysentery agent, cultured in Robinson medium were investigated. METHODS: E. histolytica cysts and trophozoites isolated from a patient with amebiasis were cultivated in the medium, incubated at 37 degrees C for a period of 4 days and 40x10(4)/ml amebic cysts were then transferred to a fresh medium. At the second stage, 0.05, 0.1 and 0.2 mM of selected metal ions were added to the medium, and the effects of these ions on parasitic reproduction compared with the control group were observed. RESULTS: It was determined that the number of living parasites in all the groups containing metal ions decreased significantly starting from 30 minutes (P<0.01). CuCl2 showed the highest lethal effect on E. histolytica cysts, whereas the lowest lethal effect was observed with CoCl2. It was also seen that the number of living cells was decreased as the ion concentration and exposure time were increased, and that there were no living parasites in the medium at the end of 24 h (P<0.01). CONCLUSION: It may be stated that the effect of ever-increasing contamination of the environment with metal waste materials on parasites should be investigated further

Editorial: Parasites in the Tropic—A New Paradigm Shift

The highlight of this eBook is to bring new insights into parasites in the tropic. To achieve that, much has been discussed about risk assessment, infection rates, disease burden, hormones and mechanism of immune response, genetic expression and susceptibility as well as, therapeutic modalities. Authors raised hypothesis, discuss concepts, and show open questions. The remaining important issues to resolve questions within parasites in the tropic – a new paradigm shift are briefly discussed below. T. gondii, feline as the definitive host, is regarded as one of the most important parasites in the tropic. Human, as an accidental host, is the only species who still drinks raw milk or milk products particularly from animal sources. Based on the first paper, the author simplifies on how safe to drink milk to prevent the transmission of T. gondii by the insistence on heat treated milk before consumption. It is interesting to explore how hormone plays its role in Toxoplasma infection. Based on the second paper, the authors elucidated from thirty studies from humans, animals and cell cultures. Of these, it was shown that Toxoplasma infection was controlled by the presence of hormones found in different animal models. However, it is still premature to conclude which hormone that has a significant relationship with Toxoplasma infection. It estimates that one-third of the world population infected with T. gondii but the majority are asymptomatic. Based on the third paper, it demonstrated that people having low prevalent of Toxoplasma infection by having close contact with animals. This study will enhance positive attitudes for more people to be committed towards helping animals. For more than three decades, T. gondii has since been identified as one of the most important opportunistic parasitic pathogens in immunocompromised. Seroprevalence of chronic toxoplasmosis was detected in at least one-third of HIV-infected individuals in the regional hospital of southern Thailand, as reported from the fourth paper. Thailand has successfully formulated anti-retroviral therapy for HIV/AIDS patients and as a result reported a rare incidence of AIDS-related cerebral toxoplasmosis (CT) in this setting. Based on the fifth paper, the authors demonstrated low IL-10 (Th2 response) and IFN-γ (Th1 response) as well as high TNF-α were produced in ocular and cerebral toxoplasmosis in AIDS patients. This might be due to South American strains and/or the genetic susceptibility of the host.Due to high genetic diversity of T. gondii in Brazil, the sixth paper demonstrated that Calomys callosus survived chronically infected by T. gondii clonal type II strain and reinfected by Brazilian strains. However, congenital toxoplasmosis occurred leading to damaging effects of the developing fetus. The seventh paper conducted a questionnaire-based study on knowledge and practice on Toxoplasma infection among pregnant women from Malaysia, Philippines and Thailand. It clearly demonstrated that health education, a core value, is the cheapest and the best option to envisage the preventive strategies of feto-maternal toxoplasmosis from this region. For treatment modality of congenital toxoplasmosis, a novel experimental therapeutic synergism of diclazuril plus atovaquone combination shows a promising outcome with no toxicity in treating this condition, as demonstrated in the eighth paper. However, it warrants for future trials to prove its properties against T. gondii in different clinical scenarios of human toxoplasmosis for more effective therapeutic regimens. In the ninth paper, the author discussed the pathogenesis of maternal and congenital toxoplasmosis, the current treatment in clinical practice, and the experimental treatment approaches for promising future trials. Overall, this protozoan represents the most extraordinary example of parasite in the tropic and beyond scientific imagination. Hence, there are still many challenges ahead and waiting for more explorations on T. gondii, the parasite that never dies. Based on the findings from the tenth paper, it is interesting to identify common gene targets between Glossina p. gambiensis and Glossina m. morsitans that might shed some lights as a suitable candidate for controlling both acute and chronic forms of sleeping sickness. This therefore requires further investigations using proteomic analysis to ascertain the corresponding genes and its proteins as well as functional role that may help the search for more novel therapeutic agents

Anti-Toxoplasma gondii Antibodies in Patients With Schizophrenia—Preliminary Findings in a Turkish Sample

Schizophrenia is a serious neuropsychiatric disease of uncertain etiology. We investigated the seropositivity rate for anti-Toxoplasma IgG and IgM antibodies by enzyme-linked immunosorbent assay (ELISA) in patients with schizophrenia to ascertain a possible relationship between Toxoplasma gondii and schizophrenia. We selected 100 patients with schizophrenia, 50 with depressive disorder, and 50 healthy volunteers to investigate the seropositivity rate of anti-Toxoplasma antibodies by ELISA. The seropositivity rate for anti-Toxoplasma IgG antibodies among schizophrenia patients (66%) was significantly higher than among patients with depressive disorder or healthy volunteers (P < .01). Thus, there might be a causal relationship between toxoplasmosis and the etiology of schizophrenia

Investigation of Potentially Pathogenic Free-Living Amoebae and Their In Vivo Pathogenicity in Water Supplies of Turkey

Free-living amoebae (FLA) are found widely in soil and water in the nature. Among them in which potentially pathogenic for humans and animals are known as "potential pathogenic free-living amoebae (PPFLA)". PPFLA are characterized as the causes of clinical manifestations leading to death especially in immunosuppressed people. Four genus of PPFLA (Acanthamoeba, Naegleria, Balamuthia and Sappinia) are known to be pathogenic to humans. The aims of this study were to investigate the presence of PPFLA in the water supplies in Turkey and to determine their in vivo pathogenicity. A total of 664 water samples were collected from the ponds, rivers, streams and wells found in provinces located at different regions (central, western, eastern and southeastern regions) of Turkey. These samples were initially inoculated in the monoxenic culture media and evaluated by both microscopy and polymerase chain reaction (PCR) in terms of the presence of FLA. The samples identified as positive were then cultured in axenic media, the growth of amoebae that were confirmed microscopically, were than studied with PCR for molecular characterization. The isolates that were found positive by PCR from axenic cultures were inoculated intranasally to immunocompetent and immunodeficient (athymic) [BALB/c Rag2(-/-) gamma(c)(-/-)] BALB/c mice followed by the evaluation on the 21st day by histopathological and molecular methods to investigate their in vivo pathogenicity. In our study, 143 water samples were detected as positive in monoxenic cultures and 41 of them were detected as positive in axenic cultures. Twenty of 41 samples detected as positive in axenic culture could be continued in culture for three months. As a result of PCR using primers common to SYA, only nine have been identified from 20 samples as positive. According to the result of the PCR with specific primers, all (n=9) were positive for Acanthamoeba sp., eight for Sappini sp. and five for Balamuthia mandrillaris, while none was observed Naegleria fowleri. Histopathologic examination revealed that both groups of mice that were infected with the nine isolates had normal brain tissue sections; but haemorrhages and mononuclear cell proliferation were determined in four immunocompetent and seven athymic animal lung sections. When the presence of parasites in tissue samples were evaluated by real-time PCR, Balamuthia was detected in at least one blood, lung, brain or nasal mucosa sample of the four immunocompetent mice, Sappinia sp. in four and Acanthamoeba sp. in seven immunocompetent mice infected with nine isolates. Additionally, seven Balamuthia sp., seven Sappinia sp. and eight Acanthamoeba sp. were detected in immunodeficient mice. In this study, B. mandrillaris and Sappinia sp. were the first isolated potentially pathogenic amoebae from water supplies located at different parts of Turkey. As a result awareness and precautions against suspicious water supplies used for drinking, daily use and swimming purposes should be treated more carefully

Effects of Metoprolol on Experimental Spinal Cord Ischemia-Reperfusion Injury in Rats

Aim: The aim of this study was to investigate the neuroprotective effect of metoprolol and its efficacy in reducing lipidperoxidation levels in the spinal cord ischemia-reperfusion model in rats.Material and Methods: Twenty (20) Sprague-Dawley female rats weighing between 220 gr and 280 gr were randomlydivided into 3 groups. Only laparotomy was performed in the control group, and the aorta abdominalis was revealed. Inthe groups other than the control group, clip compression was applied to the aorta abdominalis for 45 minutes. Theischemia group was not given any medication. Metoprolol was administered intraperitoneally at 0.5 mg/kg to themetoprolol group. Motor examination was made according to Tarlov scale at the 1st and 24th hours and then, spinalcords of all rat models were removed. Spinal cord tissue samples were collected for histopathological examination andfor determining malondialdehyde (MDA) level. All rats were sacrificed by draining blood after their motorexaminations.Results: According to motor examination findings at the 1st and 24th hours, metoprolol resulted in a statisticallysignificant improvement in recovery (p=0.045). Histopathological examinations revealed that metoprolol contributed toneurological recovery by reducing neuronal necrosis. MDA levels, which is an indicator of lipid peroxidation, weresignificantly lower in the metoprolol group when compared to the ischemia group (p=0.001).Conclusion: Metoprolol was found to be significantly effective in reducing and/or preventing spinal cord ischemiareperfusion injury